Thyroid Disorders in Pregnancy and Their Maternal and Foetal Outcome in Tertiary Care Centre

Abstract

BACKGROUND In pregnant women, thyroid disorders are common endocrine problems and due to non-specific symptoms and hyper-metabolic state of pregnancy they are often neglected. To know the prevalence of thyroid disorders in pregnant women and their maternal and foetal outcome was the purpose of this study. METHODS This was an observational study which was conducted from 15th November 2021 to 15th May 2022 in the Department of Obstetrics and Gynaecology, Srinivas Medical College, Mukka, (Mangalore). Registration of one fifty pregnant women attending antenatal clinic in first trimester was done. Detailed history and examination was done. Thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) level evaluation was done apart from routine antenatal investigations. RESULTS Among 150 pregnant women, the prevalence of thyroid disorders is 14 (9.31 %). Subclinical hypothyroidism 9 (6 %) was the most common thyroid disorder observed. Maternal anaemia and eclampsia was most common complication 3 each (33.33 %). 1 (11 %) was antepartum haemorrhage. Thyroid disorder occurred during the 2nd trimester 58.33 %; 25 % and 16.66 % in 1st and 3rd trimester. Most commonly observed foetal birth weight in this study were between 2 - 2.5 kgs 7 (77.77 %). Most common foetal complication observed were foetal growth restriction (five) with spontaneous abortion and intra uterine foetal demise (IUFD) (one each) was noted. Out of all thyroid disorders associated with pregnancy, subclinical hypothyroidism is the most frequently noted. Patients with subclinical hypothyroidism remain asymptomatic when not treated, but had bad obstetric and neonatal outcome, although less severe than overt hypothyroidism cases. CONCLUSIONS Timely screening of pregnant women is required during pregnancy for the prevention of pregnancy which helps in the early diagnosis and management of complications related to maternal and foetus due to thyroid disorders.